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Flat-Panel CT and the Future of OR Imaging and Navigation

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Imaging and Visualization in The Modern Operating Room

Abstract

The development of minimally invasive techniques and rapid progress in surgery require integration of advanced imaging capabilities into operating theaters. The setup of a fixed imaging system in an operating theatre where interventional and open procedures can be combined is called a hybrid operating room (OR).

The loss of natural three-dimensional (3D) vision and tactile sensing in minimally invasive surgery necessitate advanced imaging and visualization techniques. The network of different imaging modalities to visualize structures underneath the surface and navigate surgical instruments is an advantage of this new concept. A thorough understanding of current and future technology is necessary to create hybrid ORs supporting established and upcoming workflows.

Before planning a hybrid OR, a clear vision for intended use in a given hospital setting should be established. Commonly, hybrid ORs are designed for interdisciplinary usage by interventionalists, surgeons, and anesthesiologists. The multitude of requirements determines necessary resources such as location, space, and imaging equipment. Intraoperative 3D cross-sectional imaging based on cone-beam computed tomography (CBCT) evolves as an important imaging modality enabling the operator to navigate safely and efficiently based on the actual anatomy. Fusion imaging integrating preoperative imaging modalities such as computed tomography (CT) or magnetic resonance imaging (MRI) allows the use of comprehensive guidance of interventional or surgical procedures. Real-time imaging of the anatomy in 3D and overlay with endoscopy or ultrasound allows precision in highly complex procedures. With the trend towards integrated approaches to disease management, the hybrid OR will become an integral part of interdisciplinary therapy in all surgical centers.

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Authors and Affiliations

  1. Healthcare Sector, Siemens AG Healthcare, SiemensStr. 1, 91301, Forchheim, Bavaria, Germany

    Ina Schwabenland MD, Dirk Sunderbrink, Georg Nollert MD, PhD, Christoph Dickmann MD, PhD, Markus Weingarten PhD, Andreas Meyer & Philip Mewes MSc

  2. Ultrasound Business Unit, Siemens AG Healthcare, Issaquah, WA, USA

    John Benson BS, RDMS, RDCS

  3. Healthcare Sector, Siemens AG Healthcare, 23–38 Hythe Bridge Street, Oxford, UK

    Peter Mountney PhD

  4. Siemens AG Healthcare, Princeton, NJ, USA

    Li Zhang PhD

  5. CT RTC ICV, Siemens Corporation, Corporate Technology, 755 College Road East, Princeton, NJ, USA

    Li Zhang PhD

  6. R&D, IRCAD of Strasbourg, 1, place de l’hôpital, Strasbourg, France

    Stéphane Andre Nicolau PhD

  7. R&D, IRCAD-IHU of Strasbourg, 1, place de l’hôpital, Strasbourg, France

    Luc Soler PhD

  8. Maunakea Technologies, 18 West State St, Suite 208, 18901, Doylestown, PA, USA

    Chris Tihansky BS, MBA

Authors
  1. Ina Schwabenland MD
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  2. Dirk Sunderbrink
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  3. Georg Nollert MD, PhD
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  7. John Benson BS, RDMS, RDCS
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  9. Peter Mountney PhD
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  10. Li Zhang PhD
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  11. Stéphane Andre Nicolau PhD
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  12. Luc Soler PhD
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  13. Chris Tihansky BS, MBA
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Corresponding author

Correspondence to Ina Schwabenland MD .

Editor information

Editors and Affiliations

  1. Department of Surgery, City of Hope National Medical Cente, Duarte, California, USA

    Yuman Fong

  2. General & Robotic Surgery, University of Illinois at Chicago Division of Minimally Invasive, Chicago, Illinois, USA

    Pier Cristoforo Giulianotti

  3. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Jason Lewis

  4. Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands

    Bas Groot Koerkamp

  5. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Thomas Reiner

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Schwabenland, I. et al. (2015). Flat-Panel CT and the Future of OR Imaging and Navigation. In: Fong, Y., Giulianotti, P., Lewis, J., Groot Koerkamp, B., Reiner, T. (eds) Imaging and Visualization in The Modern Operating Room. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-2326-7_7

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  • DOI: https://doi.org/10.1007/978-1-4939-2326-7_7

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